Permit WI
n FIRE PROTECTION SYSTEM PERMIT
: CITY OF TIGARD
''' 2 . '" COMMUNITY DEVELOPMENT Permit #: FPS2009-00093
-tI Ag D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/13/2009
Parcel: 25101 DB00100
Jurisdiction: Tigard
Site address: 7320 SW HUNZIKER RD 200
Subdivision: Lot: 0
Project: Angel Vision
Project Description: Relocate (1) fire sprinkler head.
Owner: FEES
HILLTOP BUSINESS CENTER LLC & Description Date Amount
HUNZIKER LLC, 9430 NW KAISER RD Permit Fee - COM 10/1312009 $62.50
PORTLAND, OR 97231 12% State Surcharge - Building 10/13/2009 $7.50
PHONE:
Contractor:
FIRESTOP CO
3203 NE 65TH ST. #2
VANCOUVER, WA 98663
PHONE: 360- 718 -8604
FAX: 360- 718 -8603
Type of Use: COM
Class of Work: FPS Type of Const:
Occupancy Grp: Height: ft
Stories:
Commercial Sprinkler System:
Sprinkler Required: Sprinkler Type:
Standpipe Required: Hazard:
Density: Design Area: ,
K Factor:
Commercial Fire Alarm System:
Fire Alarm Required: Alarm Type:
Pull Station Required: Smoke Detectors Req:
Battery Calcs Provided: Cut Sheets Required:
Total $70.00
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: 900
Residential Square Footage:
Fire Alarm Valuation:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started ithin 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules opted by the Oregon
Utility • . ation Cen e . ose rul- .re set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You ma ob ain a py of the rules
or ect questions to OUNC b 4 ling 0 •x..6699 or 1.800.332.2344.
Issued By: \ 04 I / 1 / Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Building Permit Application le, • r --••,•/,
•
Fire Protection System FOR OFFICE USE ONLY •
2
City g of TI and Received 2 / Permit No :r Date /B o / 3 . �/
M
v 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 Dale /By' Other Penmt
Inspection Line: 503.639.4175 Date Ready /By. fur' ® See Page 2 for
TIGARD Internet: www.tigard or.gov Notified/Method: (r Supplemental Information
'+`d3." =,sr�,S' ' ar-^ gk'.xs.r1= :g.� ;7;%'ta.;' �r;° / q :;,•yi,Y� :;x n;? ' :q?a:' Y � -. sY #' 3 �yt2^ w r. �s' ,�x9' °�R, ?SSD- '::.,e.- i: v-t% >: „: s".;.,;=
�>! '' d."t-", "`" ^}" i -` i a`;2 `'M-i'.m,'':.: -N i,i i'9.iCrGxd t: `wr3- _i'x't'2, e ...d.. .. ; -. - . , ''f gt e §F-s° 4', -p� , nY?:,S ti'.- 'S..'.^ ¢l . S , v� j k, r.. Y y > q t q k 3+ - ,a
1 + ' r * �'� Y:PE OE "W,. . ,, - ` r r .4 N`RE9i1 1 .AN 2 F 'IILY� LING
�i'���'� €yes' . 4 i ;u . _*ten. S " - ' �.h d `,-� ,��'` ,.�`a :;r� 4 "`:�f4�.- `�."� °x'a" '��"3a,' %aa-�z �+',� ^ :.x ,.
F."` 5_ �k; ��' r�rci1 .��zP= kta'.�.,me.�.*, 5.: 3.,..i�G :.iSta'St�fX��_ "3+�_' Ft, ea� }a` >� J- :,,.aR.. �.`�a;- .� °,.= .:vn".�. s•.i.. rii"U. fl.1 1w,�,u...a.',5d ��?':- "a: ;���c " -�, �.,v t�:�.+tf,'.+"c" ",ii- :`� } ^- isL'u.sm - -�. - m'
❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
'ddition/alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
. �` ,,, �.., ft ., ,r %.� n'f; �,r.. .; :� s;r °F• r ,�. •s. ; , >°
-�� t� � �" � � � � �+ �y'i= � CATEGORY�OF CONSTRiJCTIOI�fi � �� �. �- c�z ;��s���� � �°"���� 1, ;' work indicated on this application. i
i
Mt" F V,VAI.iY,10awF.c Jxhl- a? „.£ti.`r..[.3 -'- ; aft, :sm4y1 4., gr�� kkA., -', W.' -
-3
Valuation: $
❑ 1- and 2- family dwelling Commercial /industrial
❑ Accessory building Number of bedrooms:
❑ Multi -famil y
❑ Master builder ❑ Other: Number of bathrooms:
::• a , ;�., :.: s,. x w, :c. , r�~�.a ,f : e -_, z: a� �1:> .; r`' - y . _”` Total number of floors:
=,°t 'y a6 K JOB ,:41 INkOR'1�IE�'TION.A'ND 'LOG'A t =, ,..4. 1
. c „: ~,;
��'��tS >�'.?*s.';��� , �- �, i��' �ar& �` �` a. xd;-. k�. cs�.-'. �s>: a" C• h�W` 5S'. n�n >.ru s l s:"i , ':s ..;a x�v s:'�.�':'.tt,?„J rvY :y t..�, j �,,. , .s'``, ,a ? .,r� c , , .-
3 p (�t.� ( 4 tti � , Z /1 ey
Job site address: t 1/ New dwelling area: square feet
City /State /ZIP: /
l �� / _
Garage /carport ra: square feet
Suite/bldg./apt. no Project name: hl 2I u k ii,'h � Covered po area: square feet
Cross street/directions to job site: Deck a: square feet
Ot r structure area: square feet
ra as s , n^ a °. r a a w . x.. ey.�a- - ' i
R'airl WI AT:A GOMME,RCIAtAra'CHECKI:IST; `"
Subdivision: Lot no.: Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
Tax map /parcel no.: equipment, materials, labor, overhead, and the profit for the
n 'zza += P; a' ,;_> ..r h ri' *i'ls' :.x.'. , " _ °> lti: s `n:',:'r 3;y h work indicated on this application.
t,,� - ; LEJA. r i" �.,
, .ptit_' , x s . _- w,$ ;:.t DES�RIPTIOIV OF,a WQRK iKtr, i"C mzOr "tiagg ,47, � . °"a s
� � � '• gam
P' LG� 1 5p ✓st P 14 -t-- L .0i-A - V S
Existing building area: square feet
New building area: square feet
b':,... ?€'f,:.' i;,- „Al td.; '`':n#s it �.J.`r. ;�,*+:tu x;;:.'. °�';t, ¢ ..;. rF
tea' :: k mm '; , Number of stories:
;` ar'� ;1e ; PRO A I• e , . ER : _ :; ` ` g -- ` .�: . t T ENANT= , s > �r ` d=,
a::;`= �' ,�?',y; �e�.,:�'4���ct w,:� �Qfia,3�'' -g»;�` s��•�,�v'�.`=�.s.` raw_:-;:; �:? s:.> �: �° �.. �, c� ',a�:as';�: "d ��`�'is*�;:x�..
Name: A N � v ' 5 t ) Type of construction:
Address: si „----e Occupancy groups:
City /State /Z1P: Existing:
Phone: ( ) Fax: ( ) New:
....�.,- ,..,:.a- ° . , .0 -m,�k .�.....,.:-'; ^. ,:..*_ - ,"st,9.d d: ; { a'yi ; i,a�s.,d^::ex -y
wt - � ::�x, �,� x,� =1, Y; Q•x�� , ..t�- ,yes 'i '' `� ^;��� a "':.:c" �, xr.'. •,';n�;s�:t �- , _q,�:., - , >�; v,
2«Y . PPI51(C . NT :' , ; . ,• g I .,: : aONTACT P -°• 4113: ;„ a", tPiRr£ : ' V 4 ,,
' � ., e -a.� r_.� -- a J T10E � 5t,
�asrSSt�� a�".'� e ��A?"k•�3� -k'� -s�' 7�. h.�:i �v�; .��+Pa�...�„�c� .. Et:asw- ..'� �' �' � � � �_
„ z� . ,� iS' s JS„�3^a,,s�n�'�� k`»«�� ,7r _ �a�c..�,.` a a,�,� »,
Business name: All contractors and subcontractors are required to be -
licensed with the Oregon Construction Contractors Board
Contact name: A i 2. C-. 13 (L-. ,— under ORS 701 and may be required to be licensed in the
Address: 3 Z,O3 I k.1 cos 5+. 7 jurisdiction in which work is being performed. if the
I `(y applicant is exempt from licensing, the following reasons
City /State /ZIP: 0 C c---- — / W rl 22//-� g (oCCU� /� apply:
Phone: (%O )-1 13 ` R (0(:) Fax:: vW ) l IS -8_ (o rJ
E -mail: At ( f .,-- , -��� nn
.:.�:, : -t;. ^, -� ��.a; r.--r�a " _ °.� - ?�- a'. .�.:.. r- .sr,�� - °'ka'-�t. =;�.:',se�` ,- "';e'�; °` 4� ^ `.R?r ` "'ae>;` - " %��:'s��'a� try - - - - a }, F .�`:� ^r�C: r' ;�
n r y k rsr ..su'r• w :r�:r 3ta' ,a+.r `' a .•�?Vs ,°; 'tee, ° k ., .?S .ttt3e ? ' ; l,w x e ,..
r , •o ,.." . „,,x.... a x . ,, x 4 ti �x 41 I .. BUILDIIVG FI,ES -" , ••
�. ;�. ..�. s �kx < "� �.�3, ��k� 4,COPITRA OR�� �u��.,�ttt. �• 't'� €' ��� ���' ` i „, ' � � °,.. �,. ` ,� �"
r .�3 .��€:;4 r ,.R ^..r z t'<' r ., . ,�; wr K��«ez .r;:� >• .�s:..zsG� .., ..,,r... ? > :ts .: ,'? ..::.t. - r., : 4 ' �t ,t 3" idei . eye x�x.,�.°, , sche .,u u r ex '4�+ ." A '..
1 , �, �,- ������.. ,�`, „ (P.lease�refer<tos(eersehedufel �lrak;,��
Business name:
Permit fee: 62,,5-
Address:
State surcharge (12% of permit fee): 7,:.0
City /State /Z1P: FLS plan review (40% of permit fee):
Phone: ( ) Fax: ( ) (Due upon application.) `6,^
CCB lie.: Total permit fees: 70 -
Amount received: 70 ..^) U
Authorized signature:
(1 - •
This permit application expires if a permit is not obtained
• Print name: within 180 days after it has been accepted as complete.
�I �� a ��� Date: l � * Fee methodology set by Tri- County Building Industry
4 Service Board.
1.\Buildmg \Permits \FPS - PermitAPP doc 10/01/09 440- 4613T(11 /02 /COM/WEB)
I
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information
y �xa
1.) ❑ New 2.) Modification to sprinkler heads only:
❑ Addition 1 -10 heads: No plan review required.
Xr Alteration ❑ 1 + heads: Plan review required.
El Repair
Number of sprinkler heads:
Additio9 description of work:
Ie_
Co N nn
t" :6&U
:� •.
rd:FZ:,_ §" �'vr- r,:i *ti �. "s�;" d�;$ .r�;r F,
'M1. = �:.; v, a. x'.," �;., �y; M: y. �,+„;:„;�..craetaL�,,'s'n°ss,z,
Type f Sy (Corn RIA:, ',SIP ( ` or rD OA AKP:l } _ 4 A - e
a ;31 �,Q �. .P. � ffar�� I'P .. / -�'� �.,.�w'bax_ �x . {� ?4+s._:,� � �. s�•�+;,:" =�1.
�" Imo. �. ':'s' :, > Mal" ;. S ja P" 1 y ' -9 ' + ' :i .a- .r �Pu'n i':^' - 2 d - Arer " ;'`. eitY r
W : '' " �' �: '; r 5 t� t �� �'+. '*��y [ � "�,}`.,`.� 4 ;' t r � ' �" a � :� r � �: �' sl a s `°a
tr �" .'",' r Js 1� &? .:. tea' - ?,. g 6 a z i 5+ ? " §r - v.� { �,..., r . - T
Ttm ri" be gsd m !" u ' +'�{'zdt �'% 4 . z' "b �, ? j; c 3 ±n�' "s• 'z x r , ., .# � § ?< r s '� ' ':d.'"' ' �
'"� ..sr�<.:#"s: e� �� '�. r �. ;r -� �>a � s �,� z�, i a st � `� °�^:r .m� fµ4 �
r tr:
} xa � �f < ' ,:' 33;x- ?� s
A :) Commercial Spr'<nkler p� ,. , e , 5
� mot: ,z���;,r ... i��3, �': ^MT,'�;.t'`...�,'�:+s�..�,c +o'a:,`res;:x`.�''i d;"�"�..
� - art ^'.��., ,a.�-
:
Wet ❑ Dry
Additional Standpipes
Information: " Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
3� �y' � ;;,; "",� {, ��°+«"' s6:' -`"'izsi:F;h." r'w�;� �.K',5'b* - ": ' _ �.� t �'.� �,,� tx „
��:;
o-#
p,
B.) Type: S I N ,�od�Fre�SuPression�Sys - �,v, ��..; � v =� �„
Hood Project Valuation: $
,. ".ir"a: •+} '' ss5 "' : "�.;., :c��c.� - r:. r�i�'' : <;;t _'' p' �i 'rr >s:= ?t.:; ^T•��;� ",p�"s`k".�` ^F.�a «I "�"� * "° ... pa#�
st nt 4 N `
": 1 T �}j_ U , S.t:c �'",'sK`i .��:.�13Y�t"4 'S� Y k rry, g¢p."'"F^ ;'y':.��.'i,�,•.
x !+`'� �i' *.w � � 1, i�, 'S . �d :D F' L "'u^.Y 4 1"L� , "�r �... Y # £ 'k i ea` �''*'y �a�, en•�y.
" r, i a� ��r�rs � - , . `� , q, , � „ , � ,2 k . « a -.
C-) ire Alarm it � �� r ;t � � �, _ "WS
r a: irAWM0. ,-4w .� z: :; ' t- Alffglt, ; ..3 I. .fly, . , . :' 411!, 4,
Submittal shall Battery Calculations ❑ Yes
• include: Individual Component ❑ Yes
Cut Sheets
Fire Alarm Project Valuation: $
:-.•v. °cn' - - ; +s, zc'a 'xx , y;y; ,, ^�". "�#ziz' ,`f.FV',z? ,7"at?i =; °ti°'= �a''.r; f 'df:: r ua• +-, ,�., Fyr.�° 33
a ' ��, . °,� , 5`, �` ` '; t * ,t i, ^F ' ': 2 ; '. I `4,0- ; iii `€��'-.� ,- ' 4 ' - :, _,a, -<,d 1 at
���.: r;.. =�,� �r�?�'t� � ���� t 3.. y '� i � .f��i ,� . „ �' , � is £.'•�'3a�, r '-`��' , �F' � �� � � v;
FDA Re sidential,,S,prinlder;(Stnd AloneSS stern) 6, � 01414 � 4 4 n vm r i x
Square Footage: Permit Fee: it 1 7: A - r,';r " � �
0 to 2,000 $198.75 V!
�
2,001 to 3,600 $246.45 k` fk�yY" 'x ', �
'_
�,��. s�� � t"
3,601 to 7,200 $310.05 tea
���
7,201 and greater $404.39
Sprinkler Project Square Footage: sq. ft. •
Sre� a�i'^ `;.7 �' ;.�^ ;K. =Y?•:
=.a : � *-. :�'"" ,y.3. �,��•,;� ;;+`a` °a" r.7:s? =�;�. . �. � , �. w�n, -as s.
A ,•AY 3 l , a Fite Protectro ,Permit:a ,Fe 4 .45 tea., e . > '. e.4 3,
Project valuation subtotal (see A, B & C above): $
•
Permit fee based on project valuation (see fee schedule): $
Permit fee based on square footage (see D above): $
State Surcharge (12% of permit fee): $
FLS Plan Review (40% of permit fee): $
TOTAL: $
Plan review requires a completed application and 2 sets of plans at submittal. Plan review fees are required at submittal.
I: \Building \Permits \Permit Forms 10 -01 -09 \FPS- PermitApp.doc 10/01/09 2